Surgical devices and systems with rotating end effector assemblies having an ultrasonic blade

ABSTRACT

Surgical devices and systems having rotating end effector assemblies for treating tissue are provided. Methods for using the same are also provided.

FIELD

Surgical devices and systems with rotating end effector assemblies andmethods for using the same are provided for treating tissue.

BACKGROUND

A variety of surgical devices include an end effector assembly having ablade element that vibrates at ultrasonic frequencies to cut and/or sealtissue (e.g., by denaturing proteins in tissue cells). These instrumentsinclude piezoelectric elements that convert electrical power intoultrasonic vibrations, which are communicated along an acousticwaveguide to the blade element. The precision of cutting and coagulationmay be controlled by the surgeon's technique and adjusting the powerlevel, blade edge, tissue traction and blade pressure.

Movement of the end effector assembly during use of these surgicaldevices can be important for sufficient access to tissue. In roboticsurgery, movement of the end effector assembly can also facilitatecoordinated movement of the surgeon's hands and the end effectorassembly. Any lack of movement can lead to various opportunities foruser errors, for example, inadequate cutting or sealing of tissue andaccidental damage to the anatomy during surgery. As such, it can bedesirable to have the end effector assembly move with six degrees ofmotion (e.g., surge, heave, sway, yaw, pitch, and roll).

Accordingly, despite existing technologies, there remains a need forimproved surgical devices and systems and methods for treating tissue.

SUMMARY

Surgical devices and systems and methods for using the same areprovided.

In one exemplary embodiment, a surgical device is provided and caninclude a housing having an ultrasonic transducer positioned therein, aninstrument shaft extending from the housing, and an end effectorassembly having a clamping element and an ultrasonic blade. Theinstrument shaft can include an outer sleeve having an articulableregion and a non-articulable region, a waveguide, and a rotationassembly having an inner sleeve that can be coupled to the clampingelement. The end effector assembly can be at a distal end of the outersleeve. The waveguide can be acoustically coupled with the ultrasonictransducer, where a portion of the articulable region can be alignedwith a flexible portion of the waveguide. The ultrasonic blade can be inacoustic communication with the waveguide. The inner sleeve can have amulti-segment spiral slot and a pin housed therein such that the pin canbe configured to selectively slide within the multi-segment spiral slotupon a force applied to an input operatively coupled to the pin tothereby cause rotation of the clamping element relative to theultrasonic blade. In one aspect the housing can be attached to a roboticsystem.

In some embodiments, the multi-segment spiral slot can include at leasttwo channel segments that intersect at a transition point such that thepin can translate within the at least two channels to rotate the innersleeve from about 1 degree to about 360 degrees. In such embodiments,the pin can translate in a distal direction within a first channelsegment of the at least two channel segments to cause the inner sleeveto rotate from about 1 degree to about 180 degrees in a first rotationdirection. In one embodiment, the pin can translate in a proximaldirection within a second channel segment of the at least two channelsegments to cause the inner sleeve to rotate from about 180 degrees toabout 360 degrees in the first rotation direction. In such embodiments,the pin can translate in a distal direction within the second channelsegment to cause the inner sleeve to rotate from about 1 degree to about180 degrees in a second rotation direction that is opposite the firstrotation direction. In one embodiment, the pin can translate in aproximal direction within the first channel segment to cause the innersleeve to rotate from about 180 degrees to about 360 degrees in thesecond rotation direction.

In some embodiments, the instrument shaft can include a clampingassembly coupled to the end effector assembly. The clamping assembly canbe configured to drive movement of the clamping element relative to theinstrument shaft such that the clamping element can selectively movetowards and away from the ultrasonic blade.

In some aspects, the device can also include an articulation assemblythat can be configured to selectively deflect the end effector assemblyfrom a position aligned with a longitudinal axis to a position notaligned with the longitudinal axis, where the longitudinal axis extendsalong the non-articulable region of the outer sleeve.

In another exemplary embodiment, a robotic surgical system is providedand can include an electromechanical arm having a motor disposedtherein, an instrument housing mounted to the electromechanical arm,where the instrument housing can have an ultrasonic transducer disposedtherein, an instrument shaft extending from the housing, and an endeffector assembly having a jaw and an ultrasonic blade. The instrumentshaft can include an outer sleeve having the end effector assemblyformed at a distal end thereof. The instrument shaft can also include anarticulable ultrasonic waveguide acoustically coupled to the ultrasonictransducer and extending through the instrument shaft, an actuationassembly having a first actuator rod that can be operably coupled to themotor, and a rotation assembly having an inner sleeve. The ultrasonicblade can be acoustically coupled to the articulable ultrasonicwaveguide. The inner sleeve can include first and second substantiallyspiral slots and a pin housed within one of the substantially spiralintersecting slots, where the first and second substantially spiralslots intersect with each other at a transition point. The actuationassembly can be operatively coupled to the jaw, and the first actuatorrod can be configured to axially translate relative to the outer shaftto slide the pin within the first and second substantially spiral slotsto selectively rotate the jaw while the ultrasonic blade remainsstationary. In one aspect, the transition point can be configured toallow the pin to slide from the first substantially spiral slot to thesecond substantially spiral slot such that the inner sleeve cancontinuously rotate about 1 degree to about 360 degrees.

In some aspects, the pin can translate in a distal direction within thefirst substantially spiral slot to rotate the inner sleeve in a firstrotational direction, and the pin can translate in a proximal directionwithin the second substantially spiral slot to further rotate the innersleeve in the first rotational direction. In such aspects, the pin cantranslate in a distal direction within the second substantially spiralslot to rotate the inner sleeve in a second rotational direction that isopposite the first rotational direction, and the pin can translate in aproximal direction within the first substantially spiral slot to furtherrotate the inner sleeve in the second rotational direction.

In some aspects, the instrument shaft can include a clamping assemblyhaving a jaw pull that can be configured to axially translate relativeto the outer sleeve to thereby cause the jaw to open and close so as toclamp tissue between the jaw and the ultrasonic blade.

In some aspects, the device can also include an articulation assemblythat can be configured to deflect the end effector assembly from aposition aligned with a longitudinal axis to a position not aligned withthe longitudinal axis, where the longitudinal axis extends along anon-articulable section of the outer sleeve.

Methods for using surgical devices and systems are also provided. In oneembodiment, the method can include directing a surgical device having anend effector assembly to a surgical site. The end effector assembly canbe operably coupled to an instrument shaft that contains an ultrasonicwaveguide and a rotation assembly. The end effector assembly can have anultrasonic blade and a clamping element. The rotation assembly caninclude an inner sleeve that can be operatively coupled to the clampingelement. The inner sleeve can include at least two substantially spiralslots and a pin that can be configured to slide within the at least twosubstantially spiral slots. The method can also include selectivelyrotating the clamping element relative to the ultrasonic blade,selectively actuating a clamping assembly to cause the clamping elementto move towards the ultrasonic blade to and thereby apply a clampingforce to tissue disposed between the clamping element and the ultrasonicblade, and transmitting ultrasonic energy to the ultrasonic blade totreat the tissue clamped between the clamping element and the ultrasonicblade.

In some aspects, the method can also include selectively articulatingthe instrument shaft such that the end effector assembly can beangularly oriented with respect to a longitudinal axis of a proximalportion of the instrument shaft extending from a housing. In suchaspects, the clamping element can rotate when the clamping element is inan articulated condition.

In one aspect, the clamping element can rotate in the range of about 1degree to about 360 degrees. In another aspect, the instrument shaft canbe attached to a robotic surgical system.

BRIEF DESCRIPTION OF THE DRAWINGS

This invention will be more fully understood from the following detaileddescription taken in conjunction with the accompanying drawings, inwhich:

FIG. 1 is a perspective, partially transparent view of an exemplaryembodiment of a surgical device having a rotation assembly having aninner sleeve;

FIG. 2A is a perspective, partially transparent magnified view of adistal portion of the surgical device of FIG. 1;

FIG. 2B is a partially exploded view of the distal portion of thesurgical device of FIG. 2A;

FIG. 3A is a top, partially transparent view of a proximal portion ofthe surgical device of FIG. 1;

FIG. 3B is a bottom, partially transparent view of the proximal portionof the surgical device of FIG. 3A;

FIG. 4 is a perspective view of an exemplary embodiment of a surgicalrobotic system that includes a electromechanical arm having the surgicaldevice of FIG. 1 mounted thereto, and being wirelessly coupled to acontrol system;

FIG. 5A is a perspective, partially transparent view of anotherexemplary embodiment of a distal portion of a surgical device having arotation assembly having an inner sleeve;

FIG. 5B is a partially exploded view of the distal portion of thesurgical device of FIG. 5A;

FIG. 6 is a magnified view of a portion of the inner sleeve of therotation assembly of FIG. 5A, showing exemplary movement of a pinthrough channels defined within the inner sleeve;

FIG. 7A is a side view of an exemplary inner sleeve having amulti-segment spiral slot and a pin disposed therein in which the pin isin a first position (e.g., initial position); without the inner sleevebeing rotated;

FIG. 7B is another side view of the inner sleeve in FIG. 7A showing thepin in a second position within multi-segment spiral slot in which theinner sleeve is rotated about 90 degrees;

FIG. 7C is another side view of the inner sleeve in FIG. 7A showing thepin in a third position multi-segment spiral slot in which the innersleeve is rotated about 180 degrees;

FIG. 7D is a magnified portion of the inner sleeve shown in FIG. 7C;

FIG. 7E is another side view of the inner sleeve in FIG. 7A showing thepin in a fourth position with the inner sleeve being rotated about 270degrees;

FIG. 7F is another side view of the inner sleeve in FIG. 7A showing thepin in a fifth position with the inner sleeve being rotated about 360degrees;

FIG. 8 is a side view of an exemplary embodiment of an ultrasonic bladehaving a tapered configuration;

FIG. 9 is a side view of an exemplary embodiment of an ultrasonic bladehaving tapered configuration with a concave shaped portion;

FIG. 10 is a front cross-sectional view of an exemplary embodiment of anultrasonic blade having overlapping subunits, where each subunit has asubstantially circular cross-sectional shape; and

FIG. 11 is a front cross-sectional view of an exemplary embodiment of anultrasonic blade having a cross-like configuration.

DETAILED DESCRIPTION

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those skilled in the art will understand that the devices,systems, and methods specifically described herein and illustrated inthe accompanying drawings are non-limiting exemplary embodiments andthat the scope of the present invention is defined solely by the claims.The features illustrated or described in connection with one exemplaryembodiment may be combined with the features of other embodiments. Suchmodifications and variations are intended to be included within thescope of the present invention.

Further, in the present disclosure, like-named components of theembodiments generally have similar features, and thus within aparticular embodiment each feature of each like-named component is notnecessarily fully elaborated upon. Additionally, to the extent thatlinear or circular dimensions are used in the description of thedisclosed systems, devices, and methods, such dimensions are notintended to limit the types of shapes that can be used in conjunctionwith such systems, devices, and methods. A person skilled in the artwill recognize that an equivalent to such linear and circular dimensionscan easily be determined for any geometric shape. Sizes and shapes ofthe systems and the components thereof, can depend at least on theanatomy of the subject in which the systems and devices will be used,the size and shape of components with which the systems and devices willbe used, and the methods and procedures in which the systems and deviceswill be used.

It will be appreciated that the terms “proximal” and “distal” are usedherein with reference to a user, such as a clinician, gripping a handleof a device or to a user, such as a robot, having a housing mountedthereto. Other spatial terms such as “front” and “rear” similarlycorrespond respectively to distal and proximal. It will be furtherappreciated that for convenience and clarity, spatial terms such as“vertical” and “horizontal” are used herein with respect to thedrawings. However, components of surgical device are used in manyorientations and positions, and these spatial terms are not intended tobe limiting and absolute.

Values or ranges may be expressed herein as “about” and/or from/of“about” one particular value to another particular value. When suchvalues or ranges are expressed, other embodiments disclosed include thespecific value recited and/or from/of the one particular value toanother particular value. Similarly, when values are expressed asapproximations, by the use of antecedent “about,” it will be understoodthat here are a number of values disclosed therein, and that theparticular value forms another embodiment. It will be further understoodthat there are a number of values disclosed therein, and that each valueis also herein disclosed as “about” that particular value in addition tothe value itself. In embodiments, “about” can be used to mean, forexample, within 10% of the recited value, within 5% of the recited valueor within 2% of the recited value.

For purposes of describing and defining the present teachings, it isnoted that unless indicated otherwise, the term “substantially” isutilized herein to represent the inherent degree of uncertainty that maybe attributed to any quantitative comparison, value, measurement, orother representation. The term “substantially” is also utilized hereinto represent the degree by which a quantitative representation may varyfrom a stated reference without resulting in a change in the basicfunction of the subject matter at issue.

Surgical devices that utilize ultrasonic energy to treat (e.g., cut orseal) tissue provide a particularly useful surgical option. In somesurgical situations it can be useful or necessary to move the endeffector assembly, which includes an ultrasonic blade and clamping armor element, in different orientations to access a surgical site. Whilean end effector assembly with an ultrasonic blade and clamping arm orelement can rotate in its entirety, articulation of the end effectorassembly can be more limited. For example, the ultrasonic blade can beacoustically coupled to a waveguide having a thinned section in an areawhere the blade is to bend as the end effector assembly is articulated.However, the articulation is limited to only one plane and thus a fullrange of motion of the end effector assembly cannot be achieved. Thatis, the clamping arm or element of the end effector assembly is alignedwith the articulation plane, and thus cannot be rotated out of plane. Asolution to this problem is disclosed herein in which, in addition toarticulation, the end effector assembly can be manipulated such that theclamp arm or element is able to be rotated independent of the ultrasonicblade, and thus the waveguide. The result of this feature is toeffectively enable the rotation of the clamping arm or element out ofplane of the articulation plane, thereby facilitating six degrees offreedom of the end effector assembly when it is in an articulatedcondition.

Surgical devices and systems methods of using the same are provided. Ingeneral, a surgical device is provided having at least a housing and aninstrument shaft extending therefrom. As discussed in greater detailbelow, the surgical device can be configured such that a portion of anend effector assembly can rotate while the remaining portion thereofremains stationary. In certain exemplary aspects, the instrument shaftcan include an outer sleeve having an end effector assembly at a distalend thereof. The end effector assembly can include a clamping elementand an ultrasonic blade in which the clamping element is configured toselectively rotate relative to the ultrasonic blade via a rotationassembly coupled to the clamping element. The instrument shaft can alsoinclude additional assemblies, for example, an articulation assemblythat is configured to selectively deflect the end effector assemblyand/or a clamping assembly that is configured to selectively move theclamping element towards and away from the ultrasonic blade. Thus,unlike conventional surgical devices, the surgical devices providedherein can be configured to impart the end effector assembly with sixdegrees of motion. For example, in contrast to conventional surgicaldevices, the clamping element can rotate while the ultrasonic bladeremains stationary when the end effector assembly is in articulatedconditions.

An exemplary surgical device can include a variety of features tofacilitate partial or complete movement of the end effector assembly, asdescribed herein and illustrated in the drawings. However, a personskilled in the art will appreciate that the surgical devices can includeonly some of these features and/or it can include a variety of otherfeatures known in the art. The surgical devices described herein aremerely intended to represent certain exemplary embodiments. Further, aperson skilled in the art will appreciate that the surgical devicesdescribed herein have application in conventional minimally-invasive andopen surgical instrumentation as well as application in robotic-assistedsurgery. That is, the surgical devices described herein can be disposedwithin a handle assembly designed for a hand-held device or designed tobe mounted to an electromechanical arm (e.g., a robotic arm).

As discussed in more detail below, exemplary embodiments of surgicaldevices are provided that are configured to facilitate various movementsof the end effector assembly, including rotational movement of theentire end effector assembly, selective rotation of the clamping elementrelative to the ultrasonic blade, as well as articulation of the endeffector assembly. The instrument shaft includes a rotation assemblyhaving a sliding mechanism that is configured to selectively rotate theclamping element about the ultrasonic blade while the ultrasonic bladeremains stationary. Further, the instrument shaft can include additionalassemblies, such as an articulation assembly that can facilitatearticulation of the end effector assembly. As such, the surgical devicesdescribed herein can be configured to rotate and articulate the endeffector assembly.

The surgical devices generally include a housing having an instrumentshaft extending therefrom and an end effector assembly having a clampingelement and an ultrasonic blade. The instrument shaft includes arotation assembly having an inner sleeve that is coupled to the clampingelement of the end effector assembly. The inner sleeve is designed witha sliding mechanism. The sliding mechanism can have a variety ofconfigurations. For example, as shown in FIGS. 1-2B, the slidingmechanism can have a slot-like configuration, or as shown in FIGS. 5A-6,the sliding mechanism can have a channeled configuration.

Depending at least in part on the design of the end effector assembly,the surgical device can include one or more motors that actuate one ormore assemblies of the instrument shaft as described in more detailbelow. In general, one or more motors can be used to drive varioussurgical device functions. The device functions can vary based on theparticular type of end effector assembly, but in general a surgicaldevice can include one or more motors that can be configured to cause aparticular action or motion to occur, such as opening and/or closing ofa clamping element such as a jaw, shaft and/or end effector assemblyrotation, end effector assembly articulation, energy delivery to cutand/or coagulate tissue, etc. The motor(s) can be located within ahousing of the surgical device or, in the alternative, coupled to thesurgical device such as via a robotic surgical system. As described inmore detail below, each motor can be configured to couple to or interactwith one or more drive assemblies of the surgical device, e.g., arotation drive assembly, an articulation drive assembly, a clampingdrive assembly, and/or a shaft rotation drive assembly, so that themotor can actuate one or more elements to cause a variety of movementsand actions of the device, e.g., to selectively rotate a clampingelement relative to an ultrasonic blade, to selectively articulate theend effector assembly, to selectively move the clamping element towardsand away from the ultrasonic blade, to selectively rotate the instrumentshaft, etc. The motor(s) can be powered using various techniques, suchas by a battery on or in the surgical device or by a power sourceconnected through a robotic surgical system.

In certain embodiments, as discussed in more detail below, when the atleast one motor is activated, it drives the rotation of at least onecorresponding gear assembly located within a drive assembly of thesurgical device, such as surgical devices 100 and 500 in FIGS. 1 and 5A,respectively. The corresponding gear assembly can be coupled to at leastone corresponding drive shaft, thereby causing linear and/or rotationalmovement of the at least corresponding drive shaft. While movement oftwo or more drive shafts can overlap during different stages ofoperation of the drive assemblies, each motor can be activatedindependently from each other such that movement of each correspondingdrive shaft does not necessarily occur at the same time or during thesame stage of operation.

FIGS. 1-3B illustrate an exemplary embodiment of a surgical device. Asshown, the surgical device 100 includes a housing 102, an instrumentshaft 104 extending from the housing 102, and an end effector assembly106. The end effector assembly 106 includes a clamping element 108, suchas a jaw, and an ultrasonic blade 110. In some implementations, as shownin FIGS. 1 and 2A-2B, the clamping element includes a clamp pad 109. Asused herein, “housing” is used synonymously with “instrument housing.” Aperson skilled in the art will appreciate that other ultrasonic endeffector assemblies can be used with the surgical devices disclosedherein. Further, for purposes of simplicity only, certain components ofthe housing 102 are not illustrated in FIGS. 3A-3B.

While the housing 102 can have a variety of configurations, in someimplementations, as shown in FIGS. 1 and 3A-3B, the housing 102 isconfigured to be attached to a robotic system, such as robotic surgicalsystem 400 shown in FIG. 4. Alternatively, the housing 102 can bedesigned for a hand-held device, for example as a handle housing. Aperson skilled in the art will appreciate that a housing designed for ahand-held device can require all or some of the elements disclosedherein and additional elements for operation. Details on exemplaryhousings for hand-held devices can be found, for example, in U.S. Pat.No. 9,095,367, which is incorporated by reference herein in itsentirety. Further, the housing 102 can include various drive assemblies(e.g., four drive assemblies) that are configured to drive correspondingassemblies, such as rotation assembly 141, articulation assembly 155,clamping assembly, to effect motion and action of the surgical device,as discussed in more detail below.

As shown, the housing 102 includes an ultrasonic transducer 112. Theultrasonic transducer 112 is configured to convert electrical power intoultrasonic vibrations. While the ultrasonic transducer 112 can have avariety of configurations, in some implementations, as shown in FIGS. 1and 3A-3B, the ultrasonic transducer 112 is mechanically engaged to atleast one portion of the end effector assembly 106. As described in moredetail below, in use, these ultrasonic vibrations are transmitted to atleast a portion of the end effector assembly 106. The ultrasonictransducer 112 can receive electrical power from any suitable source.For example, in some instances, the ultrasonic transducer 112 caninclude a cable 114 that directly couples the ultrasonic transducer 112with a generator 116. The generator 116 can include a power source andcontrol module that can be configured to provide a power profile toultrasonic transducer 112 that is suitable for the generation ofultrasonic vibrations through ultrasonic transducer 112. Optionally, thegenerator 116 can also be suitable for generation of RF energy.

In some embodiments, the generator 116 can include a GEN 300 sold byEthicon Endo-Surgery, Inc. of Cincinnati, Ohio. Alternatively, or inaddition to, the generator 116 can be constructed in accordance with theteachings of the following, alone or in combination: U.S. Pat. No.8,986,302, entitled “Surgical Generator for Ultrasonic andElectrosurgical Devices”; and U.S. Pat. No. 9,095,367, “FlexibleHarmonic Waveguides/Blades for Surgical Instruments, all of which areincorporated herein by reference in their entirety. Still other suitableforms that generator 116 can take, as well as various features andfunctionalities that generator 116 can provide, will be apparent tothose skilled in the art in view of the teachings herein.

In some embodiments, at least part of the functionality of generator 116can be incorporated directly into the housing 102. As an example, thehousing 102 can include an integral battery or other integral powersource, as well as any circuitry needed to condition power from abattery or other integral power source to drive ultrasonic transducer112.

As discussed above, the instrument shaft 104 extends from the housing102. While the instrument shaft 104 can have a variety ofconfigurations, in some implementations, the instrument shaft 104, asshown in FIGS. 1-2B, includes an outer sleeve 118. While the outersleeve 118 can have a variety of configurations, in someimplementations, the outer sleeve 118, as shown, has a substantiallytubular body 120 a with a substantially semi-circular tip 120 b at adistal portion thereof. As such, the distal end of the semi-circular tip120 b (e.g., a 180 degree shape) and the distal end 118 d of the outersleeve 118 are the same. It is also contemplated that the tip 120 b cantake the form of other suitable shapes and is not limited by the shapeillustrated herein.

The outer sleeve 118 includes an articulable region 124 a and anon-articulable region 124 b. As shown, the articulable region 124 a canhave a ribbed or segmented configuration that can impart flexibility tothe articulable region 124 a such that the articulable region 124 a canbend in various directions. Alternatively, or in addition, at least thearticulable region 124 a can be formed of a material that provides adesirable amount of flexibility to the outer sleeve 118. Thenon-articulable region 124 b can define a longitudinal axis (L) of thedevice 100.

In certain embodiments, an articulation member 126 can be positionedwithin the outer sleeve 118 so as to substantially align with at least aportion of articulable region 124 a of the outer sleeve 118. Thearticulation member 126 can be positioned between the tip 120 b and thenon-articulable region 124 b of the outer sleeve 118, as shown in FIG.2A. While the articulation member 126 can have a variety ofconfigurations, in certain embodiments, as shown in FIGS. 2A-2B, thearticulation member 126 can have a tubular configuration. Further, insome embodiments, the articulation member 126 can have a ribbed bodyconfiguration that is configured to align with a ribbed bodyconfiguration of the outer sleeve 118. The articulation member 126 canalso include one or more elongated recess channels 128 that at leastpartially extend along the length of the articulation member 126. Theone or more elongated recess channels 128 can be configured to allow forone or more actuator rods to extend through the instrument shaft 104 toeffect various motions of the end effector assembly 106, as described inmore detail below. Alternatively, or in addition, the articulationmember 126 can have an outer diameter that provides suitable spacebetween the inner surface 122 of the outer sleeve 118 and the outersurface 130 of the articulation member 126 so that the actuator rods canextend through this space, and consequently, through the instrumentshaft 104.

In some embodiments, a rigid member 132 can be positioned within theouter sleeve 118 so as to substantially align with the non-articulableregion 124 b of outer sleeve 118. While the rigid member 132 can have avariety of configurations, in certain embodiments, as shown in FIGS.1-2B, the rigid member 132 can have a tubular configuration. The rigidmember 132 can also include one or more elongated recess channels 134that at least partially extend along the length of the rigid member 132.The one or more elongated recess channels 134 can be configured to allowfor one or more actuator rods to extend through the instrument shaft 104to effect various motions of the end effector assembly 106, as discussedin more detail below. Alternatively, or in addition, the rigid member132 can have an outer diameter that provides sufficient space betweenthe inner surface 122 of the outer sleeve 118 and the outer surface 136of the rigid member 132 so that the actuator rods can extend throughthis space, and consequently, the instrument shaft 104.

The instrument shaft 104 can also include a waveguide 138 that extendstherethrough. As shown in FIGS. 1-2B, the waveguide 138 is in acousticcommunication with the ultrasonic blade 110. The proximal end 110 p ofthe ultrasonic blade 110 can be located at or near an antinode of thewaveguide 138. For example, as shown, the distal end 138 d of thewaveguide 138 is acoustically coupled to the proximal end 110 p of theultrasonic blade 110. The ultrasonic blade 110 can be coupled to thewaveguide 138 by any suitable means, for example, by an internalthreaded connection, a welded joint, or the like. It is alsocontemplated that the waveguide 138 and the ultrasonic blade 110 can beformed as a single unitary piece. The proximal end 138 p of thewaveguide 138 can be received within the housing 102 such that itacoustically couples to the distal end 112 d of the ultrasonictransducer 112. As such, the ultrasonic transducer 112, in use, convertsreceived electrical power to ultrasonic vibrations that are transmittedalong the waveguide 138 to the ultrasonic blade 110 to therebyfacilitate cutting and/or sealing of tissue at the treatment site. Theouter sleeve 118 of the instrument shaft 104 can isolate the outsideenvironment (e.g., the patient or other surgical device(s) or equipment)from the ultrasonic vibrations of the waveguide 138.

While the waveguide 138 can have a variety of configurations, in someimplementations, the waveguide 138, as shown in FIGS. 2A-2B, can includea flexible portion 140. As shown, the flexible portion 140 has a thinnercross-sectional area (e.g., a ribbon-like cross-sectional area shape)compared to the remaining portions of the waveguide. The flexibleportion 140 can be aligned with a portion of the articulable region 124a of the outer sleeve 118 so that the end effector assembly 106 candeflect from a position aligned with a longitudinal axis (L) of thedevice 100 to a position not aligned with the longitudinal axis (L), asdiscussed in more detail below. In this illustrated embodiment, thelongitudinal axis (L) extends along the non-articulable region 124 b ofthe outer sleeve 118. Additional details on suitable waveguides can befound in U.S. Pat. No. 9,095,367 and U.S. Patent Publication Nos.2016/0296250 and 2016/0302819, which are each incorporated by referenceherein in their entirety.

As discussed above, the instrument shaft 104 also includes a rotationassembly 141 that selectively effects rotation of the clamping element108 relative to the ultrasonic blade 110. As such, in contrast to theshaft rotation drive assembly 191 as discussed in more detail below, therotation assembly 141, and thus the rotation drive assembly 148, isconfigured to rotate the clamping element 108 while the ultrasonic blade110 remains stationary. As shown in FIGS. 1 and 2A-2B, the rotationassembly 141 includes an inner sleeve 142 that is coupled to theclamping element 108. The structural configuration of the inner sleeve142 is based at least in part on the structural configuration of otherelements of the device 100, for example, the waveguide 138 theultrasonic blade 110 itself, etc. As such, while the inner sleeve 142can have a variety of configurations, in this illustrated embodiment,the inner sleeve 142 has a tubular configuration. The inner sleeve 142can include a sliding mechanism, as described in detail below.

As shown, the sliding mechanism includes a slot 145. While the slot 145can have a variety of configurations, in some implementations, as shownin FIGS. 2A-2B, the slot 145 can have a substantially spiralconfiguration about the inner sleeve 142. The slot 145 can extendentirely through the inner sleeve 142 as shown in FIGS. 2A-2B, oralternatively, the slot 145 can extend partially through the innersleeve 142. The size and shape of the slot can vary. For example, asshown in FIGS. 2A-2B, the slot 145 extends along at least a portion ofthe inner sleeve 142. In one embodiment, the slot 145 can extend theentire length of the inner sleeve 142. A person skilled in the art willappreciate that the size and shape of the slot 145 is based at least inpart on the size and shape of the inner sleeve 142.

The sliding mechanism also includes a pin 146 a housed within the slot145. The pin 146 a extends from a pin plate 146 b that is positionedbetween the inner sleeve 142 and the articulation pull 156. As discussedin more detail below, the pin 146 a is configured to selectively slidewithin the slot 145 when a force is applied to an input operativelycoupled to the pin 146 a. Such sliding movement of the pin 146 a withinthe slot 145 causes rotation of the inner sleeve 142 relative to theouter sleeve 118, and consequently, rotation the clamping element 108relative to the ultrasonic blade 110.

For example, the pin plate 146 b, and thus the pin 146 a, is coupled toan actuator rod 147 that extends through the instrument shaft 104 andinto the housing 102. While the actuator rod 147 can extend along anyportion of the instrument shaft 104, the actuator rod 147, as shown inFIG. 3A, extends along a lower portion of the instrument shaft 104. Thislocation may be desirable because it subjects the actuator rod 147 to aminimal length change when the end effector assembly 106 is articulated,thereby preventing the rotation of the clamping element 108 duringarticulation. In use, when the actuator rod 147 is actuated, theactuator rod 147 axially translates relative to the outer sleeve 118 tothereby cause rotation of the inner sleeve 142, and consequently theclamping element 108.

In use, when a force is applied to the actuator rod 147 (e.g., by aninput operatively coupled thereto), the actuator rod 147 axiallytranslates relative to the outer sleeve 118 to thereby cause the pinplate 146 b to move causing the pin 146 a to slide within the slot 145.As the pin 146 a slides within the slot 145, the inner sleeve 142 isrotated and consequently the clamping element 108 relative to theultrasonic blade 110. That is, when actuated, the actuator rod 147 movesin a first or a second direction causing the pin 146 a to move in acorresponding direction. Depending on the directional movement of theactuator rod 147 the resulting rotation of the inner sleeve 142 and thusthe clamping element 108, can rotate in a clockwise or counterclockwisedirection. For example, in use, the actuator rod 147 can move in adistal direction causing the pin 146 a to slide toward the distal end142 d of the inner sleeve 142. As a result, the inner sleeve 142 canrotate in a first direction (e.g., clockwise) thereby rotating theclamping element to a desirable position about the ultrasonic blade 110.

The amount of rotation of the inner sleeve 142 and thus the clampingelement 108, will depend at least in part on the size and shape of theslot 145. In some embodiments, the inner sleeve 142 can rotate about 270degrees about its center axis. In other embodiments, the inner sleeve142 can rotate from about 180 degrees to about 270 degrees about itscenter axis. Further, the amount of rotation of the inner sleeve 142 canalso depend on the amount of force being applied to the pin 146 a.

The actuator rod 147 can be actuated in a variety of ways. For example,as shown in FIGS. 3A-3B, the rotation assembly 141 is operably coupledto a rotation drive assembly 148 that is configured to cause theactuator rod 147 to advance in distal and proximal directions relativeto the outer sleeve 118. The rotation drive assembly 148, which isdiscussed in more detail below, can be located within the housing andcoupled to a corresponding rotary driving disk 149, which is operativelycoupled to a corresponding motor 150. During actuation, the motor 150can actuate the rotation drive assembly 148. Exemplary motors for usewith the systems and devices disclosed herein are described, forexample, in U.S. Pat. Nos. 9,445,816 and 9,585,658 and in U.S. PatentPublication Nos. 2012/0292367 and 2015/0209059, each of which isincorporated by reference herein in its entirety. A person skilled inthe art will appreciate that the elements of the rotation drive assembly148 are not limited to what is shown in FIGS. 1 and 3A-3B, and thusother suitable rotation drive assemblies can include some or all of thefeatures of the rotation drive assemblies described herein. Further, forpurposes of simplicity, certain components of the rotation driveassembly 148 are not illustrated in FIGS. 3A-3B.

The rotation drive assembly 148 can have a variety of configurations.For example, as shown in FIGS. 3A-3B, the rotation drive assembly 148can include a rotary drive gear 151 that is in meshing engagement with agear rack 152 that is coupled to a translation block 153. Thetranslation block 153 is connected to a drive shaft 154 extendingtherefrom. The actuator rod 147 is connected to the drive shaft 154 suchthat axial movement of the drive shaft 154 causes corresponding axialmovement of the actuator rod 147. The rotary drive gear 151 can beoperably coupled to the rotary driving disk 149 which is operativelycoupled to the motor 150. In use, when the motor 150 is activated itdrives rotation of the rotary driving disk 149. The rotation of therotary driving disk 149 drives rotation of the rotary drive gear 151causing substantially linear movement of the actuator rod 147 relativeto the outer sleeve 118. It will be appreciated that the application ofa rotary output motion from the motor 150 in one direction will resultin substantially linear movement of the actuator rod 147 in a distaldirection to slide the pin 146 a towards a distal end 142 d of the innersleeve 142. Further, application of the rotary output motion in anopposite direction will result in substantially linear movement of theactuator rod 147 in a proximal direction to slide the pin 146 a towardsa proximal end 142 p of the inner sleeve 142.

The instrument shaft 104 can also include additional assemblies toeffect other motions or actions of the surgical device 100. For example,in some embodiments, the instrument shaft 104 can include anarticulation assembly 155. Alternatively, or in addition to, theinstrument shaft 104 can include a clamping assembly.

As shown in FIGS. 1 and 2A-2B, the instrument shaft 104 includes anarticulation assembly 155 that is configured to deflect the end effectorassembly 106 from a position aligned with a longitudinal axis (L) of thedevice 100 to a position not aligned with the longitudinal axis (L).Further, in combination with the articulation assembly 155, thearticulation of the end effector assembly 106 is accomplished throughthe articulable region 124 a of the outer sleeve 118, the articulationmember 126, and the flexible portion 140 of the waveguide 138. It isalso contemplated herein that other suitable articulation assemblies canbe used alone or in combination with one or more features of thesurgical devices described herein. Non-limiting examples of otherexemplary articulation assemblies can found in U.S. Patent PublicationNos. 2016/0296250, 2016/0296251, 2016/0296252, 2016/0296268,2015/0320437, 2016/0374712, 2016/0302819, which are each incorporated byreference herein in their entirety.

While the articulation assembly 155 can have a variety ofconfigurations, in some implementations, the articulation assembly 155,as shown in FIGS. 2A-2B, includes an articulation pull 156. Thearticulation pull 156 can have a variety of configurations. As shown,the articulation pull 156 has a substantially semi-circularconfiguration that complements the tip 120 b of the outer sleeve 118 andis coupled thereto. It is also contemplated herein that the articulationpull 156 can take the form of other shapes. The illustrated articulationpull 156 is coupled to two actuator rods 157, 158 that each extendthrough the instrument shaft 104 and into the housing 102. As shown, thefirst actuator rod 157 is coupled to a first side end 159 of thearticulation pull 156 and the second actuator rod 158 is coupled to asecond opposing side end 160 of the articulation pull 156.

In use, when the end effector assembly 106 is aligned with thelongitudinal axis of the device 100, actuation of the first and secondactuator rods 157, 158 can cause the end effector assembly 106 todeflect from the longitudinal axis. For example, when the first actuatorrod 157 is actuated, the first actuator rod 157 can distally advancerelative to the housing 102, and when the second actuator rod 158 isactuated, the second actuator rod 158 can proximally retract relative tothe housing 102 or vice versa. As a result, the axially translation ofthe first and second actuator rods 157, 158 facilitates articulation ofthe end effector assembly 106 at an angle relative to the longitudinalaxis. It will be appreciated that the distal or proximal movement of thefirst and second actuator rods 157, 158 relative to the housing 102drives the direction in which the end effector assembly 106 movesrelative to the longitudinal axis (e.g., a left direction (D_(L)) or aright direction (D_(R)) as shown in FIGS. 2A). Further, it will beappreciated that the movement of the end effector assembly relative 106to the longitudinal axis depends at least in part on the movement of theflexible portion 140 of the waveguide 138 relative to the longitudinalaxis. For example in some embodiments, the flexible portion 140 canarticulate about 45 degrees or less relative to the longitudinal axis inone direction. In one other embodiments, the flexible portion 140 canarticulate from about 35 degrees to 45 degrees relative to thelongitudinal axis in one direction. In one embodiment, the flexibleportion 140 can articulate from about 35 degrees to 40 degrees relativeto the longitudinal axis in one direction.

The actuator rods 157, 158 can be actuated in a variety of ways. Forexample, as shown in FIGS. 1 and 3A-3B, the articulation assembly 155 isoperably coupled to an articulation drive assembly 161 that isconfigured to cause each actuator rod 157, 158 to advance in distal andproximal directions relative to the housing 102. The articulation driveassembly 161, which is discussed in more detail below, can be locatedwithin the housing 102 and coupled to a corresponding rotary drivingdisk 149 which is operatively coupled to a corresponding motor 163.During actuation, the motor 163 can actuate the articulation driveassembly 161. Exemplary motors for use with the devices and systemsdisclosed herein are described, for example, in previously mentioned inU.S. Pat. Nos. 9,445,816 and 9,585,658 and in U.S. Patent PublicationNos. 2012/0292367 and 2015/0209059, each of which is incorporated byreference herein in its entirety. A person skilled in the art willappreciate that the elements of the articulation drive assembly 161 arenot limited to what is shown in FIGS. 1 and 3A-3B, and thus othersuitable articulation drive assemblies can include some or all of thefeatures of the articulation drive assembly 161 described herein.Further, for purposes of simplicity, certain components of thearticulation drive assembly 161 are not illustrated in FIGS. 3A-3B.

The articulation drive assembly 161 can have a variety ofconfigurations. For example, as shown in FIGS. 3A-3B, the articulationdrive assembly 161 can include a rotary drive gear 164 that is inmeshing engagement with a first gear rack 165 that is coupled to a firsttranslation block 166. The first translation block 166 is connected to afirst drive shaft 167 extending therefrom. The first actuator rod 157 isconnected to the first drive shaft 167 such that axial movement of thefirst drive shaft 167 causes corresponding axially movement of the firstactuator rod 157. The rotary drive gear 164 is also in meshingengagement with a second gear rack 168 that is coupled to a secondtranslation block 169. The second translation block 169 is connected toa second drive shaft 170 extending therefrom. The second actuator rod158 is connected to the second drive shaft 170 such that axial movementof the second drive shaft 170 causes corresponding axially movement ofthe second actuator rod 158. As shown, the first and second gear racks165, 168 oppose each other, such that the rotary drive gear 164 canconcurrently engage the first and second gear racks 165, 168.

The rotary drive gear 164 can be operably coupled to the rotary drivingdisk 162 which is operatively coupled to the motor 163. In use, when themotor 163 is activated it drives rotation of the rotary driving disk162. The rotation of the rotary driving disk 162 drives rotation of therotary drive gear 164 causing substantially linear movement of the firstactuator rod 157 relative to the housing 102 in a first direction (e.g.,distal direction). The rotation of the rotary drive gear 164 alsoconcurrently causes substantially linear movement of the second actuatorrod 158 relative to the housing 102 in a second direction (e.g.,proximal direction) that is opposite the first direction. It will beappreciated that the application of a rotary output motion from themotor 163 in one direction will result in substantially linear movementof the first actuator rod 157 in a distal direction and the secondactuator rod 158 in a proximal direction so as to move the end effectorassembly 106 in a first direction. Further, application of the rotaryoutput motion in an opposite direction will result in substantiallylinear movement of the first actuator rod 157 in a proximal directionand the second actuator rod 158 in a distal direction so as to move theend effector assembly 106 in a second direction.

As discussed above, the instrument shaft 104 can include a clampingassembly. The clamping assembly can be configured to move the clampingelement 108 relative to the instrument shaft 104 such that the clampingelement 108 can selectively move towards and away from the ultrasonicblade 110. While the clamping assembly can have a variety ofconfigurations, in some implementations, as shown in FIGS. 2A-2B, theclamping assembly includes a first pull member 172 and a second pullmember 173, collectively referred to herein as a clamp pull. The clamppull can be coupled to the clamping element 108 via a coupling element174 located at the distal end of the second pull member 173. While thecoupling element 174 can have a variety of configurations, in someimplementations, the coupling element 174, as shown, includes twoopposing channels 175 that are configured to receive complementary pinsextending from an inner surface of the proximal end of the clampingelement 108. The two opposing channels 175 can function as guides forthe complementary pins to facilitate movement of the clamping element108 towards and away from the ultrasonic blade 110.

The first and second pull members 172, 173 can have a variety ofconfigurations. The first pull member 172, as shown, has a substantiallysemi-circular configuration and is positioned between the outer sleeve118 and the inner sleeve 142. While the illustrated first pull member172 is elongated, one skilled in the art will appreciate that the lengthof the first pull member 172 can vary. The second pull member 173, asshown, has a substantially tubular configuration and is positionedbetween the waveguide 138 and the inner sleeve 142. It is alsocontemplated herein that the first and second pull members 172, 173 cantake the form of other shapes. Further, the first and second pullmembers 172, 173 are configured to engage or interact with each othersuch that axial translation of the first pull member 172, as discussedin detail below, effects corresponding axial translation of the secondpull member 173, thereby moving the clamping element 108 towards or awayfrom the ultrasonic blade 110. For example, as shown, a flange 177 islocated at the proximal end of the second pull member 173. This flange177 is configured to engage with a recessed channel 178 defined withinfirst pull member 172. This engagement also allows the second pullmember 173 to rotate with the inner sleeve 142 when the articulationassembly is actuated.

The illustrated clamp pull, in particular the first pull member 172, iscoupled to an actuator rod 179 that extends through the instrument shaft104 and into the housing 102. While the actuator rod 179 can extendalong any portion of the instrument shaft 104, the actuator rod 179, asshown, can extend along an upper portion of the instrument shaft 104.This location may be desirable because it subjects the actuator rod 179to a minimal length change when the end effector assembly 106 isarticulated, thereby preventing the clamping element 108 to move towardthe ultrasonic blade 110 during articulation. In use, when the actuatorrod 179 is actuated, the actuator rod 179 axially translates relative tothe outer sleeve 118 to thereby cause proximal or distal movement of thefirst pull member 172, and thus, the clamp pull.

In use, when the actuator rod 179 moves toward the housing 102 (e.g.,from an initial position to a proximal position), the clamp pull andconsequently the coupling element 174, retract toward the housing 102.This movement of the coupling element 174 causes the complementary pinsof the clamping element 108 to slide within the two opposing channels175 of the coupling element 174, and therefore facilitates movement ofthe clamping element 108 from its initial position (e.g., an openposition) towards the ultrasonic blade 110 (e.g., a closed position).Once the clamping element 108 is in a closed position, a person skilledin the art will appreciate that moving the actuator rod 179 away fromthe housing 102 (e.g., in a distal direction) causes the clamp pull toalso move in a similar direction. This movement causes the clampingelement 108 to move away from the ultrasonic blade 110 thereby allowingclamping element 108 to move towards or return to its initial position.That is, moving the actuator rod 179 away from the housing 102 causesthe complementary pins of the clamping element 108 to move towards orreturn to their initial position within the two opposing channels 175.

The actuator rod 179 can be advanced in a variety of ways. For example,as shown in FIGS. 1 and 3A-3B, the clamping assembly is operably coupledto a clamping drive assembly 180 that is configured to cause theactuator rod 179 to move in distal and proximal directions relative tothe outer sleeve 118. The actuator clamping assembly, which is discussedin more detail below, can be disposed within the housing 102 and coupledto a corresponding rotary driving disk 181, which is operatively coupledto a corresponding motor 182. During actuation, the motor 182 canactuate the clamping drive assembly 180. Exemplary motors for use withthe devices and systems disclosed herein are described, for example, inpreviously mentioned in U.S. Pat. Nos. 9,445,816 and 9,585,658 and inU.S. Patent Publication Nos. 2012/0292367 and 2015/0209059, each ofwhich is incorporated by reference herein in its entirety. A personskilled in the art will appreciate that the elements of the clampingdrive assembly 180 are not limited to what is shown in FIGS. 1 and3A-3B, and thus other suitable clamping drive assemblies can includesome or all of the features of the clamping drive assembly 180 describedherein. Further, for purposes of simplicity, certain components of theclamping drive assembly 180 are not illustrated in FIGS. 3A-3B.

The clamping drive assembly 180 can have a variety of configurations.For example, as shown in FIGS. 3A-3B, the rotation drive assembly 148can include three rotary gears 183, 184, 185. The first rotary gear 183is operatively coupled to the second rotary gear 184 by a drive post186. The first rotary gear 183 is also in meshing engagement with a gearrack 187 that is coupled to a translation block 188. The translationblock 188 is connected to a drive shaft 189 extending therefrom. Theactuator rod 179 is connected to the drive shaft 189 such that axialmovement of the drive shaft 189 causes corresponding axially movement ofthe actuator rod 179. The second rotary gear 184 is in meshingengagement with the third rotary gear 185. The third rotary gear 185 canbe operably coupled to the rotary driving disk 181 which is operativelycoupled to the motor 182. In use, when the motor 182 is activated itdrives rotation of the rotary driving disk 181. The rotation of therotary driving disk 181 drives rotation of the third rotary gear 185,and consequently the first rotary gear 183, causing substantially linearmovement of the actuator rod 179 relative to the housing 102. It will beappreciated that the application of a rotary output motion from themotor 182 in one direction will result in substantially linear movementof the actuator rod 179 in a proximal direction to move the clamp pulltowards the housing 102. Further, application of the rotary outputmotion in an opposite direction will result in substantially linearmovement of the actuator rod 179 in a distal direction to move the clamppull away from the housing 102 and towards the distal end of the outersleeve 118.

Alternatively, or in addition to, it may be desirable to manuallyadvance or retract the actuator rod 179. For example, as shown in FIGS.1 and 3A-3B, a rotation knob 190 can be operably coupled to the firstrotary gear 183 via the drive post 186. In use, manual rotation of therotation knob 190, and consequently the first rotary gear 183, wouldeffect axial translation of the actuator rod 179 in a similar manner asdescribed above.

In some embodiments, it may be desirable for the instrument shaft 104,and thus the entire end effector assembly, to rotate. As such, therotation of the instrument shaft 104 can be effected by using a shaftrotation drive assembly. That is unlike the rotation assembly 141 androtation drive assembly 148, a shaft rotation drive assembly asdescribed herein effects rotation of an entire end effector assembly asopposed to only rotating the clamping element associated with anultrasonic blade. For example, as shown in FIGS. 1 and 3A-3B, a shaftrotation drive assembly 191 is disposed within the housing 102. Further,for purposes of simplicity, certain components of the shaft rotationdrive assembly 191 are not illustrated in FIGS. 3A-3B.

While the shaft rotation drive assembly 191 can have a variety ofconfigurations, in some implementations, the shaft rotation driveassembly 191, as shown FIGS. 1 and 3A-3B, can include a first spiralworm gear 192 that is positioned at the proximal end 104 p of theinstrument shaft 104. The first spiral worm gear 192 is in meshingengagement with a second spiral worm gear 193 that is coupled to a firstrotary drive gear 194 via a driving post 196. The first rotary drivegear 194 is in meshing engagement with a second rotary drive gear 195that is operably coupled to a rotary driving disk 197 which isoperatively coupled to a motor 198.

In use, the motor 198 rotates the rotary driving disk 197 which drivesrotation of the second rotary drive gear 195, and consequently, thefirst spiral worm gear 192. This causes rotational movement of theinstrument shaft 104 relative to the housing 102. It will be appreciatedthat the application of a rotary output motion from the motor 198 in onedirection will result in substantially rotational movement of theinstrument shaft 104 in a first direction (e.g., a clockwise direction).Further, application of the rotary output motion in an oppositedirection will result in substantially rotational movement of theinstrument shaft 104 in a second opposing direction (e.g., acounterclockwise direction).

Over the years a variety of minimally invasive robotic (or“telesurgical”) systems have been developed to increase surgicaldexterity as well as to permit a surgeon to operate on a patient in anintuitive manner. Many of such systems are disclosed in the followingU.S. Patents, which are each herein incorporated by reference in theirrespective entirety: U.S. Pat. No. 5,792,135, entitled “ArticulatedSurgical Instrument For Performing Minimally Invasive Surgery WithEnhanced Dexterity and Sensitivity”, U.S. Pat. No. 6,132,368, entitled“Multi-Component Telepresence System and Method”, U.S. Pat. No.6,231,565, entitled “Robotic Arm DLUS For Performing Surgical Tasks”,U.S. Pat. No. 6,783,524, entitled “Robotic Surgical Tool With UltrasoundCauterizing and Cutting Instrument”, U.S. Pat. No. 6,364,888, entitled“Alignment of Master and Slave In a Minimally Invasive SurgicalApparatus”, U.S. Pat. No. 7,524,320, entitled “Mechanical ActuatorInterface System For Robotic Surgical Tools”, U.S. Pat. No. 7,691,098,entitled Platform Link Wrist Mechanism”, U.S. Pat. No. 7,806,891,entitled “Repositioning and Reorientation of Master/Slave Relationshipin Minimally Invasive Telesurgery”, and U.S. Pat. No. 7,824,401,entitled “Surgical Tool With Wristed Monopolar Electrosurgical EndEffectors”. Many of such systems, however, have in the past been unableto generate the magnitude of forces required to effectively cut andfasten tissue. Many of such systems, however, have in the past beenunable to facilitate articulation and rotation of an end effectorassembly having a clamping element and an ultrasonic blade.

The surgical device 100 can be assembled in various ways. For example,to assembly the distal portion of the surgical device 100 illustrated inFIGS. 2A-2B can include the assembly of subunits which are then coupledtogether to form the resulting distal portion. In some embodiments, theassembly of a first subunit can include coupling the articulation member126 to the rigid member 132 of the instrument shaft 104. The waveguide138 and ultrasonic blade 110, which in this illustrated embodiment are aunitary structure, can then be slide through the rigid member 132 andthe articulation member 126. After which each actuator rod 147, 157,158, 179, where actuator rod 147 includes the pin 146 a and pin plate146 b and actuator rod 179 includes the first pull member 172, can beplaced into their respective recessed channels of the articulationmember 126 and of the rigid member 132 thereby forming the firstsubunit. The first subunit is slide into the outer sleeve 118, such thatthe first pull member 172 and the pin 146 a and pin plate 146 b arelocated at the tip 120 b of the outer sleeve 118. A second subunit canbe formed by sliding the second pull member 173 and coupling element 174through the inner sleeve 142. Thereafter the clamping element 108 can beattached to both the coupling element 174 and the inner sleeve 142thereby coupling the second pull member 173 and inner sleeve 142together. The second subunit can then be inserted into the instrumentshaft 104, specifically at the tip 120 b of the outer sleeve 118. Thearticulation pull 156 can be then placed over the second subunit andwelded to the tip of the outer sleeve 118 to form the distal portion ofthe surgical device 100.

Accordingly, as discussed above, the surgical devices can be designed tobe mounted to an electromechanical arm (e.g., a robotic arm). Forexample, FIG. 4 illustrates a robotic surgical system 400 having device100 shown in FIGS. 1-3B mounted to an electromechanical arm 402. Theelectromechanical arm 402 can be wirelessly coupled to a control system404 having a console with a display and two user input devices. One ormore motors (not shown) are disposed within a motor housing 406 that iscoupled to an end of the electromechanical arm 402. The housing 102 ofsurgical device 100 is mounted to the motor housing 406, andconsequently to the electromechanical arm 402, to thereby operablycouple the motor(s) to the various drive assemblies of surgical device100. As a result, when the motor(s) are activated by the control system404, the motor(s) can actuate one or more drive assemblies. As shown inFIG. 4, the instrument shaft 104 extends from the housing 102. Duringsurgery, the instrument shaft 104 and end effector assembly 106,collectively the instrument shaft assembly for purposes of thisdescription can be placed within and extend through a trocar 408 that ismounted on the bottom of a carrier 410 extending between the motorhousing 406 and a trocar 408 support. The carrier 410 allows theinstrument shaft assembly to be translated into and out of the trocar408. Further, given that the end effector assembly 106 includes anultrasonic blade 110, a generator 116 is operably coupled to theultrasonic transducer 112 disposed within the housing 102. In use, whenthe generator 116 is activated, by the control system 404, the generator116 delivers electrical energy to the ultrasonic transducer 112. Theultrasonic transducer 112 converts the electrical energy to ultrasonicvibrations that travel along the waveguide 138 to the ultrasonic blade110 so that the ultrasonic blade 110 can cut and/or coagulate tissue atthe treatment site. The electromechanical arm 402 is configured tosupport and move surgical device 100 as a whole along one or moredegrees of freedom (e.g., all six Cartesian degrees of freedom, five orfewer Cartesian degrees of freedom, etc.).

Exemplary embodiments of motor operation and components of a housing orinstrument housing (also referred to as a “puck”) configured to becontrolled by motors are further described in International PatentPublication No. WO 2014/151952 entitled “Compact Robotic Wrist” filed onMar. 13, 2014 and International Patent Publication No. WO 2014/151621entitled “Hyperdexterous Surgical System” filed on Mar. 13, 2014, U.S.patent application Ser. No. 15/200,283 entitled “Methods, Systems, AndDevices For Initializing A Surgical Tool” filed on Jul. 1, 2016, and inU.S. patent application Ser. No. 15/237,653 entitled “Methods, Systems,And Devices For Controlling A Motor Of A Robotic Surgical Systems” filedon Aug. 16, 2016, each of which is hereby incorporated by reference inits entirety.

FIGS. 5A-5B illustrate a distal portion of another exemplary embodimentof a surgical device 500 that includes a rotation assembly 541. Asidefrom the differences described in detail below, the surgical device 500can be similar to surgical device 100 (FIGS. 1-3B) and is therefore notdescribed in detail herein. As shown, the surgical device 500 includesan instrument shaft 504 that can extend from a housing, like housing 102in FIG. 1. The instrument shaft 504 includes the rotation assembly 541and a locking mechanism. The locking mechanism can include at least onelocking assembly. As shown in FIGS. 5A-5B and described in more detailbelow, in this exemplary embodiment, the locking mechanism includes twolocking assemblies.

As shown, the rotation assembly 541 includes an inner sleeve 542 that iscoupled to a clamping element 508 having a clamping pad 509 coupledthereto. In this illustrated embodiment, the clamping element 508 is ajaw. The inner sleeve 542 extends from a first end 542 d (e.g., a distalend) to a second end 542 p (e.g., a proximal end) with an intermediatesegment 542 i extending therebetween. The inner sleeve 542 includes asliding mechanism. While the sliding mechanism can have a variety ofconfigurations, in some implementations, the sliding mechanism, as shownin FIGS. 5A-6, includes a predetermined pattern of projections 543 andone or more pins 546 a (e.g., three pins), as discussed in more detailbelow.

As shown in FIGS. 5A-6, the predetermined pattern of projections 543project radially outward from a portion of the intermediate segment 542i of the inner sleeve 542. The predetermined pattern of the projections543 define channels 545 therebetween. While the predetermined patterncan have a variety of configurations, in some implementations, thepredetermined pattern can include one or more rows of projections 543.For example, as shown in FIGS. 5A-6, the predetermined pattern includesthree separate rows 543 a, 543 b, 543 c of projections 543 that extendcircumferentially around the inner sleeve 542. In some embodiments, oneor more rows can be continuous, whereas in other embodiments, one ormore rows can be discontinuous. In the illustrated embodiment,projections 543 of the first row 543 a, which is the distal-most row onthe inner sleeve 542, are interconnected to each other at their distalends 543 d. As a result, the first row 543 a extends continuously aroundthe inner sleeve 542 so as to help prevent the one or more pins 546 afrom sliding out of engagement with the channels 545 of the inner sleeve542. The projections 543 of the second row 543 b and of the third row543 c are discontinuous. It also contemplated herein that otherpredetermined patterns of projections 543 can be used with the surgicaldevice 500.

The projections 543 within a single row can have the same shape andsize. As shown, the projections 543 within the first row 543 a have afirst shape and size, the projections 543 in the second row 543 b have asecond shape and size, and the projections 543 in the third row 543 chave a third shape. While the projections 543 within each row have thesame shape and size, it is also contemplated herein that the projections543 within a single row can have different shapes and sizes.Alternatively, the projections 543 of two or more rows can have the sameor different shape and/or size. It will be appreciated that the shapeand size of the projections 543 and the number of rows thereof depend atleast in part on the size and shape of the inner sleeve 542, andtherefore can vary accordingly.

The predetermined pattern of projections 543 is configured to definechannels 545 therebetween so that the one of pins 546 a can beselectively guided along the channels 545 in a predetermined path torotate the inner sleeve 542 in a first direction or an opposing seconddirection. That is, as discussed in more detail below, the one or morepins 546 a are configured to selectively slide within the channels 545to cause rotation of the inner sleeve 542 relative to the outer sleeve518, and consequently, rotation of the clamping element 508 relative tothe ultrasonic blade 510 when a force is applied to an input operativelycoupled to the one or more pins 546 a.

For example, as shown in FIG. 5B, three pins 546 a project radiallyinward from a distal end 546 d of a pin plate 546 b. While the pins 546a and the pin plate 546 b can have a variety of configurations, in someimplementations, as shown in FIG. 5B, the pins 546 a each have acylindrical shape and the pin plate 546 b has an arcuate configuration.An actuator rod 547 is coupled a proximal portion 546 p of the pin plate546 b, and thus the pins 546 a. While the actuator rod 547 can extendalong any portion of the instrument shaft 504, the actuator rod 547, asshown in FIG. 5A, can extend along a lower portion of the instrumentshaft 504. This location may be desirable because it subjects theactuator rod 547 to a minimal length change when the end effectorassembly 506 is articulated, thereby preventing the rotation of theclamping element 508 during articulation. When the actuator rod 547 isactuated, the actuator rod 547 axially translates relative to the outersleeve 518 to thereby cause rotation of the inner sleeve 542, andconsequently the clamping element 508.

In use, when a force is applied to the actuator rod 547 (e.g., by aninput operatively coupled thereto), the actuator rod 547 axiallytranslates relative to the outer sleeve 518 to thereby cause the pins546 a to slide within the channels 545 thereby rotating the inner sleeve542, and consequently the clamping element 508 relative to theultrasonic blade 510. That is, when actuated, the actuator rod 547 movesin a first or a second direction causing the pins 546 a to move.Depending on the directional movement of the actuator rod 547, therotation of the inner sleeve 542, and thus the clamping element 508, canrotate in a clockwise or counterclockwise direction. For example, inuse, the actuator rod 547 can move in an initial distal directioncausing the pins 546 a to slide toward the first end 542 d of the innersleeve 542. As a result, the inner sleeve 542 can rotate in a firstdirection (e.g., clockwise) thereby rotating the clamping element 508 toa desirable position about the ultrasonic blade 510. It should be notedthat the actuator rod 547 can subsequently move in a proximal directionthat causes further rotation of the inner sleeve 542 in the firstdirection as described below.

Two exemplary guide paths for the one or more pins 546 a to effectrotation of the inner sleeve 542 in a first direction D1 or a seconddirection D2 are illustrated in FIG. 6. For purposes of simplicity only,FIG. 6 illustrates the two exemplary guide paths for one pin 546 a ofthe device 500 in FIGS. 5A-5B. However, since the three pins 546 a arepositioned equidistant from each other and from the distal end 546 d ofthe pin plate 546 b, the three pins 546 a move concurrently in similarguide paths. In order to begin rotation of the inner sleeve 542 in afirst direction D1 (e.g., a counterclockwise direction when viewing thedevice 500 from its proximal end, which is opposite its distal end 500d), the actuator rod 547 distally translates relative to the outersleeve 518 thereby causing the pin 546 a to distally advance from afirst start position (PA) to a second position (P2) as shown in FIG. 6.A person skilled in the art will appreciate that the start position (PA)is exemplary and therefore the start position (PA) is not limited to theposition illustrated in FIG. 6.

As the pin 546 a begins to advance to the second position (P2), the pinplate 546 b disengages a locking mechanism, as described in more detailbelow, so that the inner sleeve 542 can rotate. As the actuator rod 547distally advances further, the pin 546 a distally advances from thesecond position (P2) to a third position (P3) to begin rotation of theinner sleeve 542 in the first direction Dl. To continue rotation of theinner sleeve 542 in the first direction D1, the actuator rod 547retracts thereby causing the pin 546 a to move from the third position(P3) to a fourth position (P4). As the actuator rod 547 retractsfurther, the pin 546 a moves from the fourth position (P4) to a secondstart position (PB₁) to further rotate the inner sleeve 542 in the firstdirection D1 and ultimately reengage the locking mechanism, as discussedin detail below. This movement of the pin 546 a (i.e., from PA to PB₁)can be repeated one or more times until the inner sleeve 542 has rotateda desirable amount in the first direction D1.

Alternatively, in order to begin rotation of the inner sleeve 542 in asecond direction D2 (e.g., a clockwise direction when viewing the device500 from its proximal end, which is opposite its distal end 500 d), theactuator rod 547 proximally translates relative to the outer sleeve 518thereby causing the pin 546 a to retract from a first start position(PA) to a second position (P5), as shown in FIG. 6. A person skilled inthe art will appreciate that the start position (PA) is exemplary andtherefore the start position (PA) is not limited to the positionillustrated in FIG. 6.

As the pin 546 a begins to retract to a second position (P5), the pinplate 546 b disengages a locking mechanism, as described in more detailbelow, so that the inner sleeve 542 can rotate. As the actuator rod 547retracts further, the pin 546 a retracts from the second position (P5)to a third position (P6) to begin rotation of the inner sleeve 542 inthe second direction D2. To continue rotation of the inner sleeve 542 inthe second direction D2, the actuator rod 547 distally advances therebycausing the pin 546 a to move from the third position (P6) to a fourthposition (P7). As the actuator rod 547 distally advances further, thepin 546 a moves from the fourth position (P7) to a second start position(PB₁) so as to further rotate the inner sleeve 542 in the seconddirection D2 and ultimately reengage the locking mechanism, as discussedin detail below. This movement of the pin 546 a (i.e., from PA to PB₂)can be repeated one or more times until the inner sleeve 542 has rotateda desirable amount in the second direction D2.

The amount of rotation of the inner sleeve 542, and thus the clampingelement 508, will depend at least in part on the size of the pins 546 a,the size of the inner sleeve 542, and the size and shape of theplurality of projections 543 and of the channels 545 definedtherebetween. In some embodiments, the inner sleeve 542 can rotate about360 degrees or less about its center axis. For example, in oneembodiment, the inner sleeve 542 can rotate from about 1 degree to about360 degrees about its center axis. In another embodiment, the innersleeve 542 can rotate about 2 degrees to about 360 degrees about itscenter axis. In another embodiment, the inner sleeve 542 can rotateabout 4 degrees to about 360 degrees about its center axis. Further, theamount of rotation of the inner sleeve 542 can also depend on the amountof force being applied to the pins 546 a.

As shown in FIGS. 5A-6, the projections 543 of the first row 543 a andthe projections 543 of the third row 543 c have substantially the sameshape except that their respective ramp surfaces extend at opposingangles. That is, the ramp surfaces of the projections 543 in the firstrow 543 a extend at a first angle (≮1), and the ramp surfaces of theprojections 543 in the second row 543 b extend at a second angle (≮2)that is opposite the first angle (≮1). As a result, the inner sleeve 542can rotate 360 degrees in opposing directions continuously. To preventthis such that the inner sleeve 542 rotates in only one direction at onetime, a locking mechanism can be within the instrument shaft 504 topromote unidirectional movement of the clamping element 508.

As mentioned above, initial movement of pin 546 a disengages a lockingmechanism to allow the inner sleeve 542 to rotate in a first directionor a second direction. While the locking mechanism can have a variety ofconfigurations, in some implementations, the locking mechanism, as shownin FIGS. 5A-5B, includes two locking assemblies. The first lockingassembly includes a first plurality of teeth 599 a that extendcircumferentially around a second end 542 p of the inner sleeve 542 anda first spring arm 539 a, configured to engage the first plurality ofteeth 599 a so as to prevent the inner sleeve 542 from rotating in thefirst direction D1 as shown in FIG. 6. The second locking assemblyincludes a second plurality of teeth 599 b that extend circumferentiallyaround a second end 542 p of the inner sleeve 542 and a second springarm 539 b configured to engage the second plurality of teeth 599 b so asto prevent the inner sleeve 542 from rotating in the second direction D2as shown in FIG. 6. Thus, each locking assembly functions as aratchet-like mechanism.

While the plurality of teeth can have a variety of configurations, insome implementations, as shown in FIGS. 5A-5B, the first and secondplurality of teeth 599 a, 599 b have a ring-like configuration about thesecond end 542 p of the inner sleeve 542.

As shown in FIG. 5B, the two spring arms 539 a, 539 b are coupled to andextending from opposing sides 559, 560 of the articulation pull 556.While the two spring arms 539 a, 539 b can have a variety ofconfigurations, in some implementations, as shown in FIGS. 5A-5B, thetwo spring arms 539 a, 539 b each have an arcuate configuration.Further, the two spring arms 539 a, 539 b are offset from each other.This is because the first spring 539 a is configured to engage the firstplurality of teeth 599 a so to prevent rotation of the inner sleeve 542in the first direction D1 shown in FIG. 6, and the second spring arm 539b is configured to engage the second plurality of teeth 599 b to preventrotation of the inner sleeve 542 in the second direction D2, shown inFIG. 6. As such, when each spring arm 539 a, 539 b is engaged with theircorresponding plurality of teeth 599 a, 599 b, the inner sleeve 542, andthus the clamping element 508, cannot rotate. As a result, as describedin more detail below, when the inner sleeve 542 rotates in a firstdirection the first spring arm 539 a is disengaged from the firstplurality of teeth 599 a while the second spring arm 539 b remainsengaged with the second plurality of teeth 599 b. Likewise, when theinner sleeve 542 rotates in a second direction, the second spring arm539 b is disengaged from the second plurality of teeth 599 b while thefirst spring arm 539 a remains engaged with the first plurality of teeth599 a.

To disengage and reengage a locking assembly, the pin plate 546 bincludes two unlock arms 544 a, 544 b that extend from opposing sides ofthe pin plate 546 b. While the two unlock arms 544 a, 544 b can have avariety of configurations, in some implementations, as shown in FIGS.5A-5B, the two unlock arms 544 a, 544 b each have an arcuateconfiguration. Further, the two unlock arms 544 a, 544 b are offset fromeach other. This is because the first unlock arm 544 a is configured todisengage the first spring arm 539 a from the first plurality of teeth599 a to allow the inner sleeve 542 to rotate in the first direction D1shown in FIG. 6 Likewise, the second unlock arm 544 b is configured todisengage the second spring arm 539 b from the second plurality of teeth599 b to allow the inner sleeve 542 to rotate in the second direction D1shown in FIG. 6. As such, the first unlock arm 544 a and the secondunlock arm 544 b can be configured to interact with the first spring arm539 a and the second spring arm 539 b, respectively, so as to disengageone of the locking assemblies to allow the inner sleeve 542 to rotate ina first or a second direction.

In use, as described above, as the pin 546 a begins to distally advanceto the second position (P2), the pin plate 546 b disengages the firstlocking assembly by moving the first spring arm 539 a. That is, as theactuator rod 547 begins to distally advance, and thus the pin 546 a todistally move from its starting position (PA), the first unlock arm 544a of the pin plate 546 b also distally moves. As a result, the distalmovement of the first unlock arm 544 a causes the first spring arm 539 ato distally move, and consequently disengage from the first plurality ofteeth 599 a. This disengagement allows the inner sleeve 542 to move inthe first direction D1 as shown in FIG. 6. The first locking assembly isdisengaged until the pin 546 a moves into the second starting position(PB₁).

As described above, to move the inner sleeve 542 in the second directionD2 as shown in FIG. 6, the pin 546 a begins to retract from it startingposition (PA) to a second position (P5), causing the pin plate 546 b todisengage the second locking assembly by moving the second spring arm539 b. That is, as the actuator rod 547 begins to proximally translate,and thus the pin 546 a from its starting position (PA), the secondunlock arm 544 b of the pin plate 546 b also retracts. As a result, theproximal movement of the second unlock arm 544 b causes the secondspring arm 539 b to proximally move. The proximal movement of the secondspring arm 539 b causes it to disengage from the second plurality ofteeth 599 b to allow the inner sleeve 542 to move in the seconddirection D2 as shown in FIG. 6. The second locking assembly isdisengaged until the pin 546 a moves into the second starting position(PB₂).

Alternatively, the locking mechanism can include a friction spring armthat is configured to apply to a predetermined frictional force to theinner sleeve 542 so as to prevent the inner sleeve 542 from rotatinguntil a driving force applied to a rotation assembly, like rotationassembly 141 in FIGS. 3A and 3B exceeds the predetermined frictionalforce. Further, the friction spring arm can be configured to allowunidirectional rotation of the inner sleeve, and therefore allow theinner sleeve to move in a first direction or a second direction oppositethe first direction. The inner surface of the friction spring arm caninclude surface features, for example, bumps extending from the innersurface, to create or enhance the predetermined frictional force to theinner sleeve 542. Alternatively, or in addition, the inner sleeve 542can include surfaces features that align with the inner surface of thefriction spring arm to create or enhance the predetermined frictionalforce.

Further, the clamping assembly of surgical device 500 in FIGS. 5A-5B issimilar to the clamping assembly of surgical device 100 in FIGS. 1-2Aexcept for the length of the first pull member 572. That is, the firstpull member 572 of surgical device 500 in FIGS. 5A-5B is shorter inlength compared to the length of first pull member 172 of surgicaldevice 100 in FIGS. 1-2B. Aside from this structural difference, theclamping assembly of surgical device 500 functions similarly to clampingassembly of surgical device 100 in FIGS. 1-2A.

FIGS. 7A-7F illustrate another exemplary embodiment of a slidingmechanism that can be disposed within a surgical device that is similarto surgical device 100 (FIGS. 1-3B). As shown, the sliding mechanismincludes an inner sleeve 242 having a multi-segment slot 245. While themulti-segment slot 245 can have a variety of configurations, in someimplementations, as shown in FIGS. 7A-7F, the multi-segment slot 245 canhave a substantially spiral configuration about the inner sleeve 242.The multi-segment slot 245 can extend partially through the inner sleeve242, as shown, or alternatively, the multi-segment slot 245 can extendentirely through the inner sleeve 242.

The multi-segment slot 245 can include at least two channel segments248, 249. The size and shape of each channel segment can vary. As shownin FIGS. 7A-7F, each channel segment 248, 249 has a substantially spiralconfiguration and extends along at least a portion of the inner sleeve242. A person skilled in the art will appreciate that the size and shapeof each channel segment 248, 249 is based at least in part on the sizeand shape of the inner sleeve 242. Further, the at least two channelsegments 248, 249 intersect at a transition point 250. This transitionpoint 250, illustrated as a black dotted line in FIGS. 7C-7D, allows apin 246 a to slide from the first channel segment 248 to the secondchannel segment 249 or vice versa. As discussed in more detail below,the inner sleeve 242 can therefore rotate (e.g., continuously rotate)from about 1 degree to about 360 degrees.

The sliding mechanism also includes a pin 246 a that is housed withinthe multi-segment slot 245. The pin 246 a can extend from a pin plate,like pin plate 146 b in FIGS. 1-3B, that is positioned between the innersleeve 242 and an articulation pull, like articulation pull 156 in FIGS.1-3B. Similar to pin 146 a in FIGS. 1-3B, pin 246 a is configured toselectively slide within the multi-segment slot 245 when a force isapplied to an input operatively coupled to the pin 246 a. As such, thesliding movement of the pin 246 a within the multi-segment slot 245causes rotation of the inner sleeve 242 relative to an outer sleeve,like outer sleeve 118 in FIGS. 1-3B. And consequently, the slidingmovement causes rotation of a clamping element, like clamping element108 in FIGS. 1-3B, relative to an ultrasonic blade, like ultrasonicblade 110 in FIGS. 1-3B. Aside from the differences described above, thesliding mechanism in FIGS. 7A-7F can be actuated like the slidingmechanism in FIGS. 1-3B discussed above.

In use, when a force is applied to an actuator rod, like actuator rod147 in FIGS. 1-3B (e.g., by an input operatively coupled thereto), theactuator rod axially translates causing the pin 246 a to slide withinthe multi-segment slot 245. As the pin 246 a slides within themulti-segment slot 245, the inner sleeve 142 is rotated. That is, whenactuated, the actuator rod moves in a first or a second directioncausing the pin 246 a to move in a corresponding direction. Depending onthe directional movement of the actuator rod relative to the outersleeve and the position of the pin 246 a within the multi-segment slot245, the resulting rotation of the inner sleeve 242, and thus theclamping element, will be in a clockwise or counterclockwise direction.FIGS. 7A-7F illustrate the inner sleeve 242 at different times during a360 degree clockwise rotation.

As shown in FIGS. 7A-7F, the pin 246 a slides in a distal direction (D)within the first channel segment 248 and in a proximal direction (P)within the second channel segment 249 to effect a 360 degree clockwiserotation of the inner sleeve 242. As a result, the clamping element canbe rotated to a desirable position about the ultrasonic blade. To beginrotation of the inner sleeve 242, the pin 246 a slides in the distaldirection from an initial position (A) located at the proximal end 248 pof the first channel segment 248 toward the distal end 248 d of thefirst channel segment 248 (FIGS. 7A-7B). The pin 246 a continues toslide through the distal end 248 d of the first channel segment 248 andthrough the transition point 250 (FIG. 7C). As shown in FIGS. 7C-7D, thetransition point 250, allows the pin 246 a to slide from the firstchannel segment 248 into the distal end 249 d of the second channelsegment 249. As a result, when the pin 246 a translates in the distaldirection (D) within the first channel segment 248, the inner sleeve 242can rotate from about 1 degree to about 180 degrees in the clockwisedirection (FIGS. 7A-7D). If further clockwise rotation is desired, thepin 246 a can then translate in the proximal direction (P) within thesecond channel segment 249 toward the proximal end 249 p of the secondchannel segment 249 (FIGS. 7E-7F). This proximal translation causes theinner sleeve 242 to further rotate from about 180 degrees to about 360degrees. As shown in FIG. 7F, the pin 246 a has reached theproximal-most end of the second channel segment 249 which is defined bya stopping element 251. This stopping element 251 also defines aboundary portion of the first channel segment 248. As such, once the pin246 a reaches the proximal-most end of the second channel segment 249,further proximal movement of the pin 246 a is prevented. Thus, the pin246 a has reached a proximal-most translation position (B), and thus,the inner sleeve 242 has rotated about 360 degrees in the clockwisedirection. A person of skill in the art will appreciate that the pin canreturn to its initial position (A) by moving distally through the secondchannel segment 249 and proximally through the first channel segment248. This pin movement can be effected, for example, by distallyadvancing the actuator rod until the pin 246 a translates through thetransition point 250, and then proximally retract the actuator rod untilthe pin 246 a reaches the proximal-most end of the first channel segment248). A person of skill in the art will further appreciate that the pin246 a can also move to and from intermediate positions (e.g., FIGS.7B-7E) to effect a desirable amount of rotation of the inner sleeve 242that is other than about 360 degrees.

It should be noted that that pin 246 a can translate continuously fromthe initial position (A) to a desired position, such as the pinpositions illustrated in FIGS. 7B-7F, and consequently, the inner sleeve242 can continuously rotate from the initial position (0 degrees) to adesired position (about 360 degrees or less, e.g., about 1 degree toabout 360 degrees). Alternatively, the pin 246 a can translate inintervals from the initial position A to the desired position.

As discussed above, an end effector assembly, like end effector assembly106 and 506 in FIGS. 1-3B and 5A-5B, respectively, can include anultrasonic blade, like ultrasonic blade 110 and 510 in FIG. 1-3B and5A-5B, respectively. As such, the ultrasonic blade can extend from afirst end (e.g., a proximal end) to a second end (e.g., a distal end) inwhich the first end can be in acoustic communication with a waveguide,like waveguide 138 in FIGS. 1-2B. In some embodiments, the ultrasonicblade can be axisymmetric. By having using an axisymmetric ultrasonicblade, the closure geometry of the end effector assembly can be the samefor any position of the clamping element.

The ultrasonic blade can have a variety of configurations. For example,as shown in FIGS. 1-2B and 5A-5B, an ultrasonic blade can have asubstantially straight (e.g., non-tapered) configuration, as shown inFIGS. 1-3B and 5-6B. Alternatively, as shown in FIG. 8, an ultrasonicblade 810 can have a tapered configuration (e.g., a conical taper fromthe first end 810 a to the second end 810 b of the ultrasonic blade810). A tapered configuration can beneficially provide additional spacefor rotating the clamping element about the ultrasonic blade.

Similarly, as shown in FIG. 9, the ultrasonic blade 910 can have atapered configuration with a concave shaped portion 911 positionedbetween the first and second ends 910 a, 910 b of the ultrasonic blade910. The concave shaped portion 911 can substantially prevent slidablemovement of tissue that is captured between a clamping element and theultrasonic blade 910. That is, the concave portion can allow forcradling of clamped tissue to aid in the dissection thereof. Theinterface of the concave shaped portion 911 with the remaining portionsof the ultrasonic blade 910 can define one or more edges 911 a, 911 b,911 c, 911 d. In some instances, the edges can be rounded. The concaveshaped portion 911 can be positioned at various distances from the firstand second ends 910 a, 910 b. In some embodiments, the concave shapedportion 911 can be positioned equidistantly from the first and secondends 910 a, 910 b of the ultrasonic blade 910. Further, in someembodiments, a clamping element that can be used with the ultrasonicblade 910 to treat tissue can include a clamp pad having a convex shapedportion complementary to the concave shaped portion 911 of theultrasonic blade 910.

Further, the ultrasonic blade can have a variety of cross-sectionalshapes. For example, the ultrasonic blade, like ultrasonic blade 110 and510, shown in FIGS. 1-2B and 5A-5B, respectively, can have asubstantially circular cross-sectional shape. Alternatively, theultrasonic blade can have two or more blade surfaces arranged around thelongitudinal axis of the ultrasonic blade in which the two or bladesurfaces define a blade cross-sectional shape profile.

For example, in some embodiments, the ultrasonic blade can have two ormore subunits that partially overlap with one another to create anoverall cross-sectional shape having a local pressure profile thatpromotes sealing of tissue that is captured between a clamping elementand the ultrasonic blade. Each subunit can have a predeterminedcross-sectional shape (e.g., a geometric shape) and surface area inwhich the summation of the surface area of each subunit is greater thana surface area of the ultrasonic blade. As shown in FIG. 10, theultrasonic blade 1010 includes three subunits 1010 a, 1010 b, 1010 c,where each subunit 1010 a, 1010 b, 1010 c has a substantially circularcross-sectional shape. The radii of each subunit 1010 a, 1010 b, 1010 ccan be sized so as to provide a local pressure profile that can enhanceeffective sealing of tissue. Further, while not necessary, the subunitunits 1010 a, 1010 b, 1010 c as shown in FIG. 10 are uniformly placedabout the ultrasonic blade with respect to angle relative to thelongitudinal axis of the ultrasonic blade.

In other embodiments, the ultrasonic blade can have two or moreintersecting blades. For example, in one embodiment, as shown in FIG.11, the ultrasonic blade 1110 can include a first blade 1110 a and asecond blade 1110 b that intersect at the central axis of the ultrasonicblade to form a cross-like cross-sectional shape. The central axisextends longitudinally between the first and second ends of theultrasonic blade. The first and second blades, collectively theultrasonic blade, can intersect each other at a variety angles. Forexample, as illustrated in FIG. 11, the ultrasonic blade 1110 includes afirst blade 1110 a and a second blade 1110 b that intersect each otherat an angle of about 90 degrees relative to each other. It is alsocontemplated herein that the first and second blades 1110 a, 1110 b canintersect each other at an angle other than 90 degrees relative to eachother. A person skilled in the art will appreciate that the intersectangle of two or more blades depend at least in part on the number ofblades and the outer diameter of each blade.

Each blade 1110 a, 1110 b can have at least one tissue-contactingsurfaces that is configured for sealing clamped tissue. Each blade 1110a, 1110 b can also have at least one tissue-contacting surface that isconfigured for back-cutting unclamped tissue. As shown in FIG. 11, eachblade 1110 a, 1110 b extends a length from a first end 1111 a, 1111 b toa second end 1112 a, 1112 b. A person skilled in the art will appreciatethat the length of each blade 1110 a, 1110 b can be varied, for example,to minimize inadvertent contact with other surfaces. Further, thelengths can change with axial positions to thereby effect the sametissue contacting surfaces as in a tapered blade. Each end 1111 a, 1111b, 1112 a, 1112 b can extend between two edges 1113 a, 1113 b. As shown,at least one edge is a fillet edge 1114. The fillet edge 1114 can beconfigured for back-cutting of unclamped tissue. As shown, the remainingedges are rounded. It will be appreciated that the geometry of the edgescan be varied. For example, in one embodiment, all of the edges can berounded. While the ultrasonic blade 1110 is not balanced with equalchamfers, it is contemplated herein that the edge features may vary,e.g., vary in size or geometry, to balance the ultrasonic blade.

As previously mentioned, the surgical devices and systems can be usedtreat tissue. Any suitable method can be used for operating any surgicaldevices and systems described herein. For example, when operating thesurgical device 100 (FIGS. 1-3B), the device 100 can be directed to asurgical site. Prior to, during, or after directing the surgical device100 to the surgical site, the clamping element 108 can be selectivelyrotated relative to the ultrasonic blade 110. In certain instances, theclamping element 108 can rotated in the range of about 1 degree to about360 degrees. Once tissue is disposed between the clamping element 108and the ultrasonic blade 110, the clamping assembly can be selectivelyactuated to cause the clamping element 108 to move toward the ultrasonicblade 110, which in turn, applies a clamping force to the tissue. Itwill be appreciated that rotation of the clamping element 108 is notnecessary for the clamping assembly to be actuated. Once tissue isclamped between the clamping element 108 and the ultrasonic blade 110,ultrasonic energy can be transmitted to the ultrasonic blade 110 (e.g.,by the ultrasonic transducer 112) to treat the clamped tissue. Incertain instances, the instrument shaft 104 is attached to a roboticsurgical system, like robotic surgical system 400 shown in FIG. 4.

In some embodiments, the instrument shaft 104 can be selectivelyarticulated such that the end effector assembly 106 is angularlyoriented with respect to a longitudinal axis of a proximal portion ofthe instrument shaft 104. As such, the clamping element 108 can rotatewhen the clamping element 108 is in an articulated condition.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, the device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces and subsequent reassembly. In particular, the devicecan be disassembled, and any number of the particular pieces or parts ofthe device can be selectively replaced or removed in any combination.Upon cleaning and/or replacement of particular parts, the device can bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Thoseskilled in the art will appreciate that reconditioning of a device canutilize a variety of techniques for disassembly, cleaning/replacement,and reassembly. Use of such techniques, and the resulting reconditioneddevice, are all within the scope of the present application.

One skilled in the art will appreciate further features and advantagesof the invention based on the above-described embodiments. Accordingly,the invention is not to be limited by what has been particularly shownand described, except as indicated by the appended claims. Allpublications and references cited herein are expressly incorporatedherein by reference in their entirety. Any patent, publication, orinformation, in whole or in part, that is said to be incorporated byreference herein is incorporated herein only to the extent that theincorporated material does not conflict with existing definitions,statements, or other disclosure material set forth in this document. Assuch the disclosure as explicitly set forth herein supersedes anyconflicting material incorporated herein by reference.

1. A surgical device, comprising: a housing; an instrument shaftextending from the housing, the instrument shaft comprising an outersleeve having an articulable region and a non-articulable region, theinstrument shaft further comprising, a waveguide that is acousticallycoupled to an ultrasonic transducer, wherein a portion of thearticulable region is aligned with a flexible portion of the waveguide,and a rotation assembly having an inner sleeve; and an end effectorassembly at a distal end of the outer sleeve, the end effector assemblyhaving a clamping element and an ultrasonic blade that is in acousticcommunication with the waveguide, wherein the inner sleeve is coupled tothe clamping element, the inner sleeve having a multi-segment spiralslot and a pin housed therein such that the pin is configured toselectively slide within the multi-segment spiral slot upon a forceapplied to an input operatively coupled to the pin to thereby causerotation of the clamping element relative to the ultrasonic blade. 2.The device of claim 1, wherein the multi-segment spiral slot includes atleast two channel segments that intersect at a transition point suchthat the pin translates within the at least two channels to rotate theinner sleeve from about 1 degree to about 360 degrees.
 3. The device ofclaim 2, wherein the pin translates in a distal direction within a firstchannel segment of the at least two channel segments to cause the innersleeve to rotate from about 1 degree to about 180 degrees in a firstrotation direction.
 4. The device of claim 3, wherein the pin translatesin a proximal direction within a second channel segment of the at leasttwo channel segments to cause the inner sleeve to rotate from about 180degrees to about 360 degrees in the first rotation direction.
 5. Thedevice of claim 4, wherein the pin translates in a distal directionwithin the second channel segment to cause the inner sleeve to rotatefrom about 1 degree to about 180 degrees in a second rotation directionthat is opposite the first rotation direction.
 6. The device of claim 5,wherein the pin translates in a proximal direction within the firstchannel segment to cause the inner sleeve to rotate from about 180degrees to about 360 degrees in the second rotation direction.
 7. Thedevice of claim 1, wherein the instrument shaft includes a clampingassembly coupled to the end effector assembly, the clamping assemblybeing configured to drive movement of the clamping element relative tothe instrument shaft such that the clamping element selectively movestowards and away from the ultrasonic blade.
 8. The device of claim 1,further comprising an articulation assembly that is configured toselectively deflect the end effector assembly from a position alignedwith a longitudinal axis to a position not aligned with the longitudinalaxis, wherein the longitudinal axis extends along the non-articulableregion of the outer sleeve.
 9. The device of claim 1, wherein thehousing is attached to a robotic surgical system.
 10. A robotic surgicalsystem, comprising: an electromechanical arm having a motor disposedtherein; an instrument housing mounted to the electromechanical arm; aninstrument shaft extending from the housing, the instrument shaftincluding an outer sleeve and further including, an articulableultrasonic waveguide acoustically coupled to an ultrasonic transducerand extending through the instrument shaft, an actuation assembly havinga first actuator rod that is operably coupled to the motor; a rotationassembly having an inner sleeve that includes first and secondsubstantially spiral slots and a pin housed within one of thesubstantially spiral intersecting slots, wherein the first and secondsubstantially spiral slots intersect with each other at a transitionpoint; and an end effector assembly formed at a distal end of the outersleeve, the end effector assembly having a jaw and an ultrasonic bladethat is acoustically coupled to the articulable ultrasonic waveguide,wherein the actuation assembly is operatively coupled to the jaw, andwherein the first actuator rod is configured to axially translaterelative to the outer shaft to slide the pin within the first and secondsubstantially spiral slots to selectively rotate the jaw while theultrasonic blade remains stationary.
 11. The system of claim 10, whereinthe transition point is configured to allow the pin to slide from thefirst substantially spiral slot to the second substantially spiral slotsuch that the inner sleeve continuously rotates about 1 degree to about360 degrees.
 12. The system of claim 10, wherein the pin translates in adistal direction within the first substantially spiral slot to rotatethe inner sleeve in a first rotational direction, and wherein the pintranslates in a proximal direction within the second substantiallyspiral slot to further rotate the inner sleeve in the first rotationaldirection.
 13. The system of claim 12, wherein the pin translates in adistal direction within the second substantially spiral slot to rotatethe inner sleeve in a second rotational direction that is opposite thefirst rotational direction, and wherein the pin translates in a proximaldirection within the first substantially spiral slot to further rotatethe inner sleeve in the second rotational direction.
 14. The system ofclaim 10, wherein the instrument shaft includes a clamping assemblyhaving a jaw pull that is configured to axially translate relative tothe outer sleeve to thereby cause the jaw to open and close so as toclamp tissue between the jaw and the ultrasonic blade.
 15. The system ofclaim 10, further comprising an articulation assembly that is configuredto deflect the end effector assembly from a position aligned with alongitudinal axis to a position not aligned with the longitudinal axis,wherein the longitudinal axis extends along a non-articulable section ofthe outer sleeve.
 16. A method, comprising: directing a surgical devicehaving an end effector assembly to a surgical site, the end effectorassembly operably coupled to an instrument shaft that contains anultrasonic waveguide and a rotation assembly, the end effector assemblyhaving an ultrasonic blade and a clamping element, the rotation assemblyhaving an inner sleeve that is operatively coupled to the clampingelement and includes at least two substantially spiral slots and a pinconfigured to slide within the at least two substantially spiral slots;selectively rotating the clamping element relative to the ultrasonicblade; selectively actuating a clamping assembly to cause the clampingelement to move towards the ultrasonic blade to and thereby apply aclamping force to tissue disposed between the clamping element and theultrasonic blade; and transmitting ultrasonic energy to the ultrasonicblade to treat the tissue clamped between the clamping element and theultrasonic blade.
 17. The method of claim 16, further comprisingselectively articulating the instrument shaft such that the end effectorassembly is angularly oriented with respect to a longitudinal axis of aproximal portion of the instrument shaft extending from a housing. 18.The method of claim 17, wherein the clamping element is able to rotatewhen the clamping element is in an articulated condition.
 19. The methodof claim 16, wherein the clamping element is able to rotate in the rangeof about 1 degree to about 360 degrees.
 20. The method of claim 16,wherein the instrument shaft is attached to a robotic surgical system.